Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHASTA KETCHAMCONNELLY, DPT
ActiveSHASTA KETCHAMCONNELLY, DPT is a Physical Therapy Assistant healthcare provider located in DANVILLE, Iowa. NPI 1104276120 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · DANVILLE, IA
Registration Details
- NPI Number
- 1104276120
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 21, 2016 (10.154202611197 yrs)
- Last Updated
- Jun 21, 2016
- Licenses
-
1221789 (TX)3843 (HI)871828 (DC)080290 (IA)
Practice Information
- Address
-
508 S 1ST AVEDANVILLE, IA, 526239609Browse IA providers · Browse ZIP 52623
- Phone
- 3197502799
- Primary Specialty
-
Physical Therapy Assistant
225100000X
- Additional Specialty
- Physical Therapy Assistant
- Additional Specialty
- Physical Therapy Assistant
- Additional Specialty
- Physical Therapy Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.